Managing care in the context of bereavement : a grounded theory study of male survivors of partners who died from AIDS

Abstract

The purpose of this study was to describe the bereavement experiences of surviving gay men who provided care for a partner who died from AIDS. In addition, a goal was to generate a substantive theory that explains a basic social process used to manage bereavement. Grounded theory method was used to collect and analyze the data. Semistructured, op~n-ended interviews were conducted with 10 participants who lived with their partners diagnosed with AIDS at the time of the death. The collection and comparative analysis of the data occurred simultaneously over a period of 2 years. The findings revealed the basic social psychological problem of bereavement resolution, the basic social process (BSP) of managing care, and three categories comprising the BSP. These categories included: Stage I -- Taking on the care, Stage II -- Sharing the Care, and Stage III Relinquish~ng the Care. In addition, the strategies of each stage which were used by the participants to respond to the challenges of providing care for the partners with AIDS were delineated as forces impacting bereavement outcomes. The strategies ~or.the stages include-d: stage I -- (a) committing to care, (b) managing alone, (c) restructuring the relationship, (d) taking care of oneself; Stage II -- (a) reaching out ·to the families, (b) seeki-;n;g the support of friends; Stage III -- (a) dealing with the health care system, (b) dealing with the families, and (c) deaiing with the final loss. Implications for practice suggest that the Managing Care Theory within the context of bereavement provides a new framework from which to assess survivors' strategies in caring for partners with AIDS. The substantive theory provides a guide for nurses and other healthcare providers to more effectively intervene with survivors in the bereavement period. This study provides a basis for future research to determine if application of the Managing Care Theory will result in more positive bereavement outcomes for the survivors whose partners died from AIDS.